Mechanisms of Change in Mindfulness-Based Stress Reduction: Self-Compassion and Mindfulness as Mediators of Intervention Outcomes
Abstract
Research has demonstrated support for the efficacy of mindfulness-based stress reduction (MBSR) in alleviating psychological distress and symptoms. Less is known, however, about the mechanisms through which MBSR achieves its outcomes. This study examined mindfulness and self-compassion as potential mediators of MBSR’s effects on several processes and behaviors related to emotion regulation, using data from a randomized trial of MBSR versus waitlist (WL), in which MBSR participants demonstrated significantly greater improvements in worry, fear of emotion, difficulties in emotion regulation, suppression of anger, and aggressive anger expression. Mediation analysis using bootstrap resampling indicated that increases in self-compassion mediated MBSR’s effects on worry, controlling for change in mindfulness. Increases in mindfulness mediated the intervention’s effects on difficulties in emotion regulation, controlling for change in self-compassion. Both variables mediated MBSR’s effects on fear of emotion. These findings highlight the importance of mindfulness and self-compassion as key processes of change that underlie MBSR’s outcomes.
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Participation in a DBT skills group may be associated with improvements in well-being and self-compassion.
“For example, given the emphasis on mindfulness (and associated skills such as letting go of judgments of oneself) as a core skillset in DBT, participation in a DBT skills group may be associated with improvements in well-being and self-compassion, outcomes that have been reported across multiple studies examining the effects of mindfulness-based interventions [25–27].”
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- Authors
- Keng, S.-L., Smoski, M. J., Robins, C. J., Ekblad, A. G., & Brantley, J. G.
- Affiliations
- Duke University (US)
- Duke Medical Center (US)
- Centre for Addiction and Mental Health (CA)
- Venue
- Journal of Cognitive Psychotherapy
- Publisher
- Springer Publishing Company
- Published
- 2012
- Volume
- 26
- Issue
- 3
- Pages
- 270-280
- ISSN
- 0889-8391 (ISSN-L)
- 1938-887X
- OpenAlex
- W2008283886
- Cited by
- 184
- References
- 47
- Citations by year
- 2026: 3 · 2025: 11 · 2024: 8 · 2023: 15 · 2022: 13 · 2021: 25 · 2020: 20 · 2019: 18 · 2018: 13 · 2017: 22 · 2016: 11 · 2015: 7 · 2014: 11 · 2013: 5 · 2012: 2
- FWCI
- 9.08
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Cognitive Psychotherapy (publishedVersion)
- Funders
- Johns Hopkins University
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- mindfulness-based stress reduction, self-compassion, mindfulness, mechanisms of change, emotion regulation, worry, fear of emotions, anger suppression, psychological distress, mediation
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